Rodriguez-Alvarez M, Santos-Magadan S, Rodriguez-Jimenez B, Reig-Rincon de Arellano I, Vazquez-Cortes S, Martinez-Cocera C
Allergy Department. Hospital Clínico San Carlos. Madrid. Spain.
Allergol Immunopathol (Madr). 2008 Jul-Aug;36(4):201-4.
Delayed reactions with betalactam antibiotics are a very common reason for consultation and a matter of numerous publications.
To demonstrate that delayed reactions occurring during treatment with betalactam antibiotics are not reproduced in a high percentage of the patients, when making drug challenge. To analyse the characteristics of people showing this type of reaction.
We included in our study all the patients who came to our Allergy Department during one year (2004), with a clinical history of delayed reaction (> 72h) to betalactams. Skin prick tests (SPT), intradermal tests (IT) and patch tests were carried out, followed by simple blind placebo controlled drug challenge (SBPCDC) at hospital and home treatment with betalactams.
We studied 23 patients (12 men and 11 women), average age 23.4 years old. SPT and patch test were negative in all patients. Only one patient showed positive IT tests, and allergic reaction was only reproduced in two patients; 76 % tolerated the drug involved in supposed allergy.
Simple blind oral challenge with implicated drug followed by home treatment is required for a conclusive diagnosis of allergy in patients with delayed reactions to betalactams.
β-内酰胺类抗生素的迟发性反应是会诊的常见原因，也是众多出版物探讨的主题。
证明在进行药物激发试验时，β-内酰胺类抗生素治疗期间发生的迟发性反应在高比例患者中不会重现。分析出现此类反应的人群特征。
我们纳入了2004年一年内到我院过敏科就诊、有β-内酰胺类抗生素迟发性反应（>72小时）临床病史的所有患者。进行了皮肤点刺试验（SPT）、皮内试验（IT）和斑贴试验，随后在医院和家中使用β-内酰胺类抗生素进行简单盲法安慰剂对照药物激发试验（SBPCDC）。
我们研究了23例患者（12名男性和11名女性），平均年龄23.4岁。所有患者的SPT和斑贴试验均为阴性。只有1例患者IT试验呈阳性，且只有2例患者再现了过敏反应；76%的患者耐受了疑似过敏所涉及的药物。
对于有β-内酰胺类抗生素迟发性反应的患者，要确诊过敏，需要用相关药物进行简单盲法口服激发试验并随后进行家庭治疗。
